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Availability of Specialty Health Care for Rural American Indians and Alaska Natives
An issue of concern that has been identified by providers in WWAMI region is the availability of specialty services to American Indian and Alaskan Native (AI/AN) populations. This study has three primary aims:
- To assess the level of access to medical and surgical specialty services for AI/ANs in Montana and New Mexico;
- To identify a network of sites caring for AI/ANs throughout the WWAMI region that can serve as a base for research in AI/AN health issues; and
- To identify a research agenda in rural AI/AN health in our region, consulting with our network of practice sites.
The primary source of information regarding access to specialty services was a mail survey with telephone follow-up of primary care providers in Montana and New Mexico who work in Indian Health Services and tribal health facilities, regarding their patients' access to specialty care, and strategies they have used to improve access to specialty services. We also surveyed a random sample of other primary care providers from the same communities to identify whether specialty access difficulties are specific to AI/AN populations, or reflect the overall community.
Publications
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Access to Specialty Health Care for Rural American Indians in Two States
Author(s): Baldwin LM, Hollow WB, Casey S, Hart LG, Larson EH, Moore K, Lewis E, Andrilla CHA, Grossman DC
Citation: Journal of Rural Health 24(3), 269-278
Date: 2008
The Indian Health Service (IHS), whose per capita expenditure for American Indian and Alaska Native (AI/AN) health services is about half that of the US civilian population, is the only source of health care funding for many rural AI/ANs. Specialty services, largely funded through contracts with outside practitioners, may be limited by low IHS funding levels. This study outlines the examination of specialty service access among rural Indian populations in two states. Results indicate that limitations in specialty care access for rural Indian clinic patients appear to be influenced by financial constraints. Health care systems factors may play a role in perceived differences in specialty access between rural Indian and non-Indian clinic patients.
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Access to Specialty Health Care for Rural American Indians: Provider Perceptions in Two States
Author(s): Laura-Mae Baldwin, Waler B. Hollow, Susan Casey, L. Gary Hart, Eric H. Larson, Kelly Moore, Ervin Lewis, David C. Grossman
Report Number: Working Paper No. 78
Date: 10 / 2004
Examines access to specialty services among rural Indian populations in Montana and New Mexico, based on a survey sent to primary care providers addressing access to specialty physicians, perceived barriers to access, and access to nonphysician clinical services. Report available upon request by contacting rhrc@fammed.washington.edu.
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